Mounting evidence suggests there is a strong relationship between asthma and obstructive sleep apnea (OSA), whereby each disorder deleteriously influences the other. However, little is known regarding which condition leads to the other. Understanding the initiating processes of the potentially self-reinforcing asthma–OSA cycle could help reduce the burden of both conditions. Asthma & OSA: Chicken or the Egg? For a study published in JAMA, Mihaela Teodorescu, MD, MS, and colleagues examined the asthma–OSA relationship among a cohort of patients without OSA at baseline. Self-reported asthma and asthma duration were recorded beginning in 1988, and laboratory-based sleep studies were conducted every 4 years through 2013. “We followed the incidence of OSA in asthmatics versus non-asthmatics,” says Dr. Teodorescu. The study team found that asthma increased the risk of OSA development at 4 years by about 40%. At the first 4-year follow-up, 27% of patients with asthma experienced incident OSA, compared with a 16% rate among those without asthma. Similar rates of OSA were observed when looking across the full study period. The researchers found the association between OSA and asthma was not significantly affected by: ♦ Baseline and 4-year changes in BMI, neck or waist girth, or waist-to-hip ratio. ♦ Menopausal status. ♦ Asthma controller use. ♦ The availability of follow-up polysomnography. “Our findings suggest that asthma most likely leads to the development of OSA, regardless of the presence of predisposing factors for sleep apnea,” adds Dr. Teodorescu. The researchers added that the longer patients had suffered from asthma, the higher their likelihood was of developing OSA. “This has important implications for younger populations because asthma starts to develop during...

As COPD progresses, patients with the disease experience more frequent bouts of shortness of breath and exacerbations. Activities of daily living become increasingly difficult, often leaving family members to take over household chores that had always been performed by their loved one with COPD. These individuals may also have more frequent visits to the emergency department (ED) that result in hospitalization, which in turn can take family caregivers away from their preferred lifestyles and cause tremendous stress. Addressing Caregiver Burden The burden placed on family caregivers is worsening because COPD continues to rise in prevalence and is now the third leading cause of death worldwide, according to the World Health Organization. “Unfortunately, public awareness of COPD is very low,” says Sidney S. Braman, MD, FACP, FCCP. “Any efforts to increase awareness have focused mostly on patients and their suffering, but there has been little focus on family members and the impositions placed on them that come with caring for a person with COPD.” To help highlight COPD as a progressive disease with a large impact on family caregivers, the COPD Foundation, with support from Sunovion Pharmaceuticals Inc., developed the COPD Together campaign. The campaign’s website—www.copdtogether.com—helps family caregivers understand the disease and its progression. It also provides information on avail-able medications and other treatment options, such as pulmonary rehabilitation, as well as preventative options. Lifestyle tips, information on self-care, and a COPD caregiver’s guide are other important features of the campaign. “COPD patients and their caregivers can both use the My Diary tool to track medications, satisfaction levels, and symptom occurrence and progression,” adds Dr. Braman. “This tool can aid...

Healthcare is a hot topic in the media these days. Yet, few people are satisfied with the way it is working. Many claim that the American healthcare system is broken. Patients are increasingly frustrated with finding a doctor, getting tests and medications they need, and paying for out-of-pocket expenses. Numerous doctors are disenchanted with their career choice, and burnout is a common complaint. Frequently, doctors are now looking to retire early or for alternate career paths. Treating patients has become unfulfilling for many due to administrative burdens, increasing government regulations, and overbearing insurance over-sight. Doctors fight daily to get procedures and medications covered that their patients need. Most often, the battle is with someone who is not even a doctor or has any clue about the patient. These daily battles become wearing. Additionally, doctors now have to fight on a more abundant basis to get paid for services they provided. Their incomes are stagnant or shrinking while overhead costs are soaring. Increasingly, doctors are selling out their practices and joining large groups and hospitals. “When I go in the exam room and close the door, I face my patient and am again reminded of why I became a doctor: to alleviate suffering.” Many people look to put blame on doctors for the broken healthcare system. Yet, it has been years since doctors truly had any control over it. More often these days, doctors are treated like pawns and servants, our independence and integrity being worn away and questioned. But, who really is to blame for the broken healthcare system? 1. Commercial insurance companies who have no oversight and...